The opinion of the court was delivered by: COHILL
MAURICE B. COHILL, Jr., Chief Judge
Proceeding pro se, the plaintiff, a Pennsylvania resident, filed this action on February 4, 1987, in the Court of Common Pleas of Allegheny County, Pittsburgh, Pennsylvania, at No. G.D. 87-1831. A liberal reading of the plaintiff's original and amended complaints reveals that he contends that Blue Cross of Western Pennsylvania and Pennsylvania Blue Shield were his primary medical insurance providers while he was a federal employee and that they have wrongfully withheld certain medical benefits from him which he is entitled to under the terms of his agreement with them.
The defendants removed the case to this Court in April, 1987, and it was reassigned to this Judge on December 16, 1987, when it became apparent that this case is related to another which we previously decided. We will now remand this action to the Court of Common Pleas of Allegheny County, as we find that this Court does not have subject matter jurisdiction.
Pursuant to the Federal Employee Health Benefits Program (FEHBP), the federal Office of Personnel Management (OPM) contracts for and approves health benefit plans covering federal employees. See 5 U.S.C. §§ 8901-13. The defendants operate a plan approved by the OPM. The plaintiff alleges that he was covered by the defendants' plan and that the defendants have failed to fulfill their obligations to him. Since there is not complete diversity between the parties, we would have to find that the dispute here, solely between an alleged plan participant and an approved plan, arises "under the Constitution, laws, or treaties of the United States" in order to retain jurisdiction. 28 U.S.C. § 1331. This is a novel issue which has not been addressed by the Court of Appeals for the Third Circuit.
We conclude that there is no federal question involved in this lawsuit and will adopt the reasoning of the Tenth Circuit Court of Appeals in Howard v. Group Hospital Service, 739 F.2d 1508 (10th Cir. 1984), a case which addressed the identical issue presented here. Unfortunately, the defendants did not even cite this case, much less attempt to distinguish it; it falls on all fours with the instant case.
The court recognized that where the federal government has an articulable interest in the outcome of a dispute, federal law will govern its resolution. Id. at 1510. However, the plaintiff's claim was not against the United States and did not seek funds from the United States Treasury. The court could not foresee "how various state court adjudications of FEP benefits claims [would] frustrate the operation of that program or conflict with a specific national policy." Id. at 1511.
Blue Cross argued that because the OPM has a procedure to review denials of benefits to plan participants, to permit state courts to apply state law in interpreting the benefits policy would conflict with the federal scheme. Id. The court found, however, that the review procedure was designed to permit OPM to resolve major conflicts between itself and the carrier over the interpretation of the plan. Id. The court then cited regulations which contemplate that claims for recovery under the plans should not involve the government. In 5 C.F.R. § 890.105(a), it is stated that "OPM does not adjudicate individual claims for payment or service under health benefit plans." Another regulation states: "An action to recover on a claim for health benefits should be brought against the carrier of the health benefits plan." 5 C.F.R. § 890.107.
The court found that state court awards in FEHBP actions do not have a sufficiently direct effect on the federal treasury to necessitate federal jurisdiction. Id. It held that the benefits plan was a "federal contract authorized by federal law and negotiated by OPM, but the rights under the contract belong to the participants." Id. at 1512. A case arising out of a denial of benefits "is a private controversy in which the federal government simply does not have an interest sufficient to justify invoking federal question jurisdiction." Id. See also Lopez v. Blue Cross of Louisiana, 386 So.2d 697, 699 (La. App. 1980) (state contract law governs contract action by federal employee against FEHBP insurance carrier for improperly withheld benefits).
We agree with the Howard decision. Like Howard, the case here involves a contract entered into between private parties; there is no federal question apparent on the face of the plaintiff's complaint. Furthermore, there is no federal statute that has any relevance to the issue of whether the plaintiff was entitled to benefits under the terms of his agreement with the defendants. The FEHBP merely sets forth the manner in which the OPM will grant private health plan providers a franchise to provide benefits to federal employees and the rules which the providers must follow in doing so. This case presents a question of contract interpretation that will be governed by Pennsylvania contract law and not by the provisions of the FEHBP.
Furthermore, there is no policy of health insurance between the plaintiff and the federal government. Nor does the government insure that the plaintiff will receive benefits from the various carriers. The government has merely granted the defendants the franchise to contract with federal employees for health insurance.
We also take note of Section 8912 in the FEHBP. That section provides that the "district courts of the United States have original jurisdiction, concurrent with the United States Claims Court, of a civil action or claim against the United States founded on this chapter." 5 U.S.C. § 8912. (emphasis added). The government is not a party to this action. If Congress had intended that district courts have jurisdiction over private actions by plan participants against plan providers, we believe it would have explicitly stated so.